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The Art of Immunotherapy. | LitMetric

The Art of Immunotherapy.

J Allergy Clin Immunol Pract

Department of Medicine, Division of Allergy/Immunology, National Jewish Health, Denver, Colo. Electronic address:

Published: January 2024

AI Article Synopsis

  • - The selection of a patient for allergy immunotherapy (AIT) involves assessing their allergy history, symptom severity, and motivation for treatment to determine if AIT is appropriate.
  • - Options for AIT include sublingual immunotherapy (SLIT) for fewer allergens with safer application, or subcutaneous immunotherapy for multiple allergens with potentially higher initial effectiveness.
  • - The paper discusses challenges in administering AIT, such as managing reactions, treatment gaps, and strategies to improve patient adherence.

Article Abstract

Selection of a patient with rhinitis/conjunctivitis or asthma for allergy immunotherapy (AIT) requires several decisions. First, does the patient's sensitization, pattern of exposure to an allergen, and degree of exposure to that allergen reasonably suggest a causal relationship? Does the level and duration of symptoms warrant the cost and inconvenience of immunotherapy, or is the patient motivated by the disease-modifying potential of AIT? If AIT is selected, is the choice to be greater safety and convenience with sublingual immunotherapy (SLIT) tablets, but with treatment probably limited to 2 or 3 allergens, or for subcutaneous immunotherapy where multiple allergen therapy is the rule and efficacy may be somewhat greater, at least initially, or does the physician go off-label into the unknowns of liquid SLIT? Are there extracts of sufficient potency to achieve likely effective doses? How does the physician deal with large local or systemic reactions, with gaps in treatment, with pollen seasons, and the use of premedication or cautionary prescription of epinephrine autoinjectors? How can adherence to AIT be improved? These and other questions are addressed in this paper.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jaip.2023.10.039DOI Listing

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